Spatio-temporal dynamics of hand, foot and mouth disease in Malaysia, 2009–2019
File(s)
Published version
Author(s)
Cox, Victoria M
Jahis, Rohani
Abu Bakar, Rehan Shuhada
Yusof, Noriah Mohd
Pilay, Kiroshika Pillay Veel
Type
Journal Article
Abstract
Hand, foot and mouth disease (HFMD) is endemic in Asia-Pacific. There is geographic variability in the timing of HFMD outbreaks throughout the year across the region, and seasonality becomes less clear towards tropical regions. We used syndromic HFMD case surveillance data from 2009 to 2019 (N = 354,769 cases) to characterise the spatio-temporal dynamics of HFMD in Malaysia, which has a tropical climate, and identify factors associated with transmission. Despite the absence of regular annual seasonal patterns of incidence, HFMD epidemics were highly synchronised across districts within Peninsular and East Malaysia, but less so between the two regions. Median estimates of the state-level daily effective reproduction number (Rt) ranged from 0.47 to 1.54. Meteorological factors were found to have a small effect on HFMD transmission compared to the depletion of susceptibles (as a proxy for population immunity) and school closures, likely due to the low seasonal weather variability across the year. Studies using wider spatial scales covering a diversity of climate regions are needed to identify meteorological factors determining the timing of HFMD epidemics across Asia-Pacific countries.
Editor(s)
Lau, Eric HY
Date Issued
2025-06-09
Date Acceptance
2025-05-24
Citation
PLoS Neglected Tropical Diseases, 2025, 19 (6)
ISSN
1935-2727
Publisher
Public Library of Science (PLoS)
Start Page
e0013174
End Page
e0013174
Journal / Book Title
PLoS Neglected Tropical Diseases
Volume
19
Issue
6
Copyright Statement
© 2025 Cox et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
License URL
Identifier
10.1371/journal.pntd.0013174
Publication Status
Published
Article Number
e0013174
Date Publish Online
2025-06-09